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研究生:林光中
研究生(外文):Kuang-Chung Lin
論文名稱:遠距醫療及遠距教學的應用—線上學習之減重計劃
論文名稱(外文):Weight Loss Program Based on Telemedicine and Distance Learning
指導教授:邱泓文邱泓文引用關係
指導教授(外文):Hung-Wen Chiu
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:醫學資訊研究所
學門:醫藥衛生學門
學類:醫學技術及檢驗學類
論文種類:學術論文
論文出版年:2005
畢業學年度:93
語文別:中文
論文頁數:68
中文關鍵詞:遠距醫療遠距學習減重計畫身體質量指數
外文關鍵詞:TelemedicineDistance learningWeight-loss programBody mass index
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論文名稱:遠距醫療及遠距教學的應用 — 線上減重計劃
臺北醫學大學醫學資訊研究所
研究生姓名:林光中
畢業時間:九十三學年度 第二學期
指導教授:邱泓文副教授 臺北醫學大學醫學資訊研究所



目前國內醫療院所普遍開設減肥門診/體重控制班/運動減重班,而現行減重計畫,計畫參與者須在院方指定的時間到院,經由門診 – 飲食營養諮詢課程 – 有氧運動課程之系列性的行程實施配合,來執行此減重計畫;遠距醫療是藉助無時空限制的通信與資訊科技,來交換相隔兩地之病患的醫療臨床資料及專家意見,以克服空間及時間的障礙。本研究融合減重計畫中節食計畫、體能活動計劃以及行為療法之概念;應用遠距醫療的概念,以及遠距學習計劃的設計與實施,配合減重計畫的療程,希望能夠證明網路減重班的成效,並藉此了解設置網路減重班的架構及限制條件。幫助網路學習者甚或一般民眾達到控制體重的成效,進而維持健康的身體及生活。

系統之建置主要在於架設網路減重班相關之軟硬體,輔以百略醫學BMI22網站作為飲食及體能活動登錄之輔助工具;並透過學員社群形成心理支持。

實驗主要針對受測因子包含體重、身體質量指數(BMI)、體脂肪率、腰圍、臀圍等五項進行比較。在經過三個月的實驗期並蒐集相關之數據後,發現網路減重班的確能夠達到成效,而相關系統的設置均利用現行的資訊技術及視訊會議軟體,建置成本及技術門檻均屬相當普及的層次,有利於未來之改善及推展;進一步分析結果顯示實驗組與對照組在受測因子的部份,實驗組除了體脂肪、對照組除了臀圍外,其餘各數值都達到有意義的改變;而對照組減重效果大致優於實驗組。歸納結論,實驗組因為透過無空間、時間限制的網路,互動性比起對照組高;但缺乏醫院監督的效果,持續性較對照組低。

關鍵字:遠距醫療
遠距學習
減重計畫
身體質量指數
Title of Thesis : Weight Loss Program Based on Telemedicine and
Distance Learning
Author : Kuang-Chung Lin
Thesis advised by : Hung-Wen Chiu Ph.D.
Professor
Graduate Institute of Medical Informatics
Taipei Medical University


Most of the hospitals now have established anti-fat related out-patient diagnosis or programs in helping people to overcome obesity. For current practice patient enrolled in the program need to go to hospital at a specific timeframe to join the program for health review, diet consulting, or exercise training. With the realization of concepts of telemedicine together with distance learning, it could be more convenient for patients to participate in the programs without usual limitations of time and place availability.

In this study, we implemented a system using current off-the-shelf information technologies of software and hardware, to set up a virtual classroom on the Internet for a weight-loss program. The purpose of this study was to prove that a weight-loss program based on telemedicine and distance learning could be as effective as the ordinary face-to face process which patients need to visit hospital periodically. In addition, protocols with this study investigated the limitations and possible improvements for setting up a Internet weight-loss program.

Volunteers of this experiment were divided into two groups, virtual class and traditional class, without any baseline differences in body weight, BMI, body fat %, waist circumference, and hip circumference. After a 3-month weight-loss program, data had been collected for comparison between the 2 groups. The results, however, showed that the weight-loss program of the virtual class is acceptable and effective; improvements of the participants are slower than those of the traditional class. Members in virtual class had better interactions with the medical stuffs due to the features brought out by telemedicine and distance learning. On the other hand, inconsistency of enrollments were noted because of unavailability of direct monitoring, which was the key successful factor for a weight-loss program, either in a virtual or a traditional class.

Key words : Telemedicine
Distance learning
Weight-loss program
Body mass index
第一章 緒論
1.1 研究動機
1.2 研究目的
1.3 論文架構
第二章 文獻探討
2.1 肥胖定義與治療
2.1.1 肥胖的種類
2.1.2 肥胖的治療
2.1.3 節食計劃
2.1.4 體能活動
2.1.5 行為療法
2.1.6 輔助工具
2.2 遠距醫療
2.2.1 構成條件
2.2.2 應用方式
2.2.3 應用範圍
2.2.4 設計實施要件
2.2.5 有效性
2.3 遠距學習計劃
2.3.1 課程發展原則
2.3.2 學員參與意願
2.3.3 學習成效評估
第三章 研究方法與內容
3.1 減重班實施內容
3.2 研究架構
3.2.1 軟硬體架構
3.2.2 應用程式說明
3.2.3 輔助工具說明
3.3 研究方法
第四章 結果
4.1 網路減重班 虛擬教室系統建置
4.2 出席狀況調查結果
4.3 輔助工具使用狀況
4.4 減重成效資料分析
4.5 課程實施問卷調查結果
第五章 結論與討論
5.1 結論
5.2 討論
5.3 研究限制與未來展望
參考文獻
專書
英文文獻
電子資料
參考文獻

專書
National Institutes of Health, National Heart Lung and Blood Institute, and North American Association for the Study of Obesity. 2000. The practical guide: identification, evaluation, and treatment of overweight and obesity in adults. NIH. Bethesda, Maryland, USA. Publication no. 00-4084, Oct.2000

麥夏美譯,Daniel Loiqerot & Karrie Adamany原著,《彼拉提斯輕百科》,台北:山岳出版社,民84.04。


英文文獻
Balch DC, Tichenor JM (1997) Telemedicine Expanding the Scope of Health Care Information.J Am Med Inform Assoc. 4: 1-5

Baranowski T (2004) Why combine diet and physical activity in the same international research society? Int J Behav Nutr Phys Act. 1: 2

Chun J, Kim H, Lee SG, Choi J, Cho H (2001) A DBMS-based Medical Teleconferencing System. J Am Med Inform Assoc. 8: 460-467

Demiris G (2003) Integration of Telemedicine in Graduate Medical Informatics Education. J Am Med Inform Assoc.10: 310-314

Hersh WR, Helfand M, Wallace J, Kraemer D, Patterson P, Shapiro S, Greenlick M (2001) Clinical outcomes resulting from telemedicine interventions: a systematic review. BMC Med Inform Decis Mak. 1: 5

Hersh WR, Junium K, Mailhot M, Tidmarsh P (2001) Implementation and Evaluation of a Medical Informatics Distance Education Program J Am Med Inform Assoc. 8: 570-584

Holtum E, Zollo SA (1998) The Healthnet project: extending online information resources to end users in rural hospitals. Bull Med Libr Assoc. 86: 569-575

Kedar I, Ternullo JL, Weinrib CE, Kelleher KM, Brandling-Bennett H, Kvedar JC. (2003) Internet based consultations to transfer knowledge for patients requiring specialised care: retrospective case review. BMJ. 326: 696-699

Kirk SF, Harvey EL, McConnon A, Pollard JE, Greenwood DC, Thomas JD, Ransley JK (2003) A randomised trial of an internet weight control resource: The UK Weight Control Trial. BMC Health Serv Res. 3: 19

Korner J, Aronne LJ (2003) The emerging science of body weight regulation and its impact on obesity treatment. J Clin Invest. 111: 565-570

Lin JC (1999) Applying Telecommunication Technology to Healthcare Delivery. IEEE EMB Mag ;18:28–31

Mair F, Whitten P (2000) Systematic review of studies of patient satisfaction with telemedicine.BMJ. 320: 1517-1520

McNeill KM, Weinstein RS, and Holcomb MJ (1998) Arizona Telemedicine Program : Implementing a Statewide Health Care Network. J Am Med Inform Assoc. 5: 441–447

Perednia DA, Allen, A (1995) Telemedicine technology and clinical application. JAMA 273:483-8

Riley,R.E. (1999) Popular weight loss diets. Health and exercise implications Clin. Sports Med. 18, 691-701,

Sherry L. (1996) Issues in distance learning. Int J Educ Telecomm.1:337–65.

Wiksten DL, Spanjer J, LaMaster K (2002) Effective Use of Multimedia Technology in Athletic Training Education.J Athl Train. 37(4 suppl): S-213-S-219.

Wright KE, Stewart J, Wright VH, Barker S (2002) eLearning: Is There a Place in Athletic Training Education? J Athl Train. 37(4 suppl): S-208-S-212

Zundel KM (1996) Telemedicine: history, applications, and impact on librarianship. Bull Med Libr Assoc. 84: 71–79.


電子資料
行政院衛生署NII遠距醫療網頁 / 計劃目的, 行政院衛生署, Available at : http://www.doh.gov.tw/newdoh/90-org/org-1/nii/2.htm. Accessed Nov 01, 2004
台北醫學大學醫學資訊研究所 / 教學宗旨,Taipei Medical University, Available at : http://gimi.tmu.edu.tw/gimi/1.php. Accessed Nov.01, 2004

萬芳醫院 / 肥胖防治中心, 萬芳醫院, Available at : http://www.anti-fat.idv.tw/. Accessed Nov.01, 2004

百略醫學科技BMI22 / 我的 DietBook, 百略醫學科技股份有限公司, Available at : http://www.holy-soc.com.tw/bmi22/. Accessed May 24, 2005

康健網站 / 健康生活, 康健雜誌, Available at : http://www.commonhealth.com.tw/content/071/071222.asp. Nov.01, 2005

eDiets.com, Available at : http://www.edietsuk.co.uk/index.cfm. Accessed May 13, 2005

National Education Association (NEA) and Blackboard Inc., Study Finds 24 Measures of Quality in Internet-Based Distance Learning. NEA Web site. Available at : http://www.nea.org/nr/nr000321.html. Accessed Feb 22, 2005

Weight Watchers.com, Available at : http://www.weightwatchers.com/international.aspx. Accessed May 13, 2005
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